In the tumultuous early hours of the Eaton fire’s eruption, Rhea Cruz Magpantay and 12 others hid in her 500-square-foot office on Foothill Boulevard. Sat atop her desk, a disoriented Magpantay, 46, counted everyone huddled on the carpet floor: family members, friends, three pets — a fraction of those she’d consider herself responsible for over the next harrowing months.
Her young niece broke the silence. “Tía, what are we going to do?”
“I don’t know. I actually don’t know,” Magpantay replied.
The distraught faces of loved ones, her mother silently cradling their patriarch’s urn and the deafening lack of an answer would remain vivid among Magpantay’s flurried blur of memories in the fire’s wake.
“Why? This is the first time I don’t have an answer,” she’d later say, her parents’ eldest child. “Myself, I always have an answer to everything.”
In January, one of the deadliest wildfires in California history ravaged Altadena and parts of northeast Pasadena. The blazes left 19 dead, more than 14,000 acres charred, 9,000 structures in ashes and thousands displaced.
Historic neighborhoods were flattened. Stores left standing were shuttered. But Magpantay clocked in everyday, her role as managing director of 1Heart Care Services Pasadena more important than ever to the dozens of patients and care workers relying on her to keep the senior home care agency running.
Filipino health-care workers like Magpantay are at the frontlines of assisted living and residential care facilities, overrepresented among health care occupations in the United States. Yet their work has largely been unseen and the community, left bearing the brunt of unabating disasters.
Just two days after the Eaton fire began on Jan. 7, emergency crews evacuated nearly 1,400 residents from more than 35 care facilities in the Pasadena-area. Evacuation entailed not just getting patients to safety, but ensuring relentless 24-hour medical care and supervision — all the while some health-care workers were personally affected.
The Los Angeles fires displaced nearly 200 Filipinos and an unknown number of which were Filipino nurses, according to the Philippine Consulate.
And during the pandemic, demand on these workers disproportionately affected deaths in the Filipino American community; in California, Filipino nurses accounted for 11 of 16 COVID-19 deaths, according to the California Nurses Association.
Each year, millions of people in the United States are displaced from their homes because of fires, hurricanes and other disasters — and then find themselves struggling to rebuild their lives, as Magpantay did.
Magpantay survived the fire that touched thousands and claimed at least 19 lives. But what does it mean to survive as part of what some call an “invisible” community on the frontlines?
A blur of memories in fire’s wake
When Magpantay arrived at the Pasadena Convention Center at 8 a.m. on Jan. 8, it was after a sleepless night spent cooped up with 12 others in a hotel room.
The night before, a concerned friend had set Magpantay up with a room at the Sheraton Los Angeles San Gabriel, just miles down the road from the 1Heart office where she’d found refuge.
While her family slept, Magpantay called clients and coordinated caregivers to evacuate her 20 patients from the fire zone.
That night, two of 1Heart’s facilities situated on Washington Boulevard succumbed to the flames.
One of Magpantay’s employees — a fellow Filipino caregiver — carried an elderly client down from the third floor of a smoke-filled assisted living facility with the help of a firefighter.
At dawn, Magpantay left the hotel to drive to the Convention Center. Overnight, hundreds of nursing home evacuees and their medical professionals fled to the Convention Center, Civic Center and other trusted sites.
Magpantay’s priority was to look for her clients and caregivers among the countless, to make sure everyone was safe. When she arrived at the Convention Center around 8 a.m. with blankets and additional supplies, the scene looked like a “war zone.”
Evacuees were wrapped in Red Cross blankets. Some were barely clothed, barefoot and just in diapers or ash-covered hospital gowns.
“But I was calm. I was not thinking about anything,” Magpantay recalled. “I just needed to look after my clients and caregivers.”
Magpantay said she doesn’t remember much of the next 12 hours — just that she’d managed to secure a hotel for displaced patients and continued to coordinate ongoing evacuation efforts. She doesn’t recall how she felt.
“I couldn’t remember. I was probably in shock, but the leader in me needs to step up because this is the time I have to and I know that they are looking at me,” she later said. “When my niece looked at me that night and I saw my mom, blank faced, I was just shocked.”
The next five months would be what felt like a muddled extension of the fire’s arduous first days.
Her insurance had given her an allowance of less than $250 a night for hotel rooms, with the provision that the group of 13 could not share a room. She had to book four hotel rooms at a time — an expensive and laborious task as local hotels flooded with fellow evacuees. Realizing the housing situation would be unsustainable, Magpantay managed to secure housing for her extended family who stayed with a friend in Las Vegas.
“My friend said, ‘Come, let them come here if you want, you can come here too.’ I said, ‘I cannot, I cannot, I’m gonna have to be with 1Heart.’”
So Magpantay and her husband and son moved between eight hotels in the span of five months — often paying out of pocket to cover what insurance wouldn’t — before they were finally permitted to return to their home in early May. Her husband, Lloyd, helped with organizing the moving, while employed at his own full-time job as a project manager for Kaiser.
Between packing, moving and clocking in over 65 hours a week at 1Heart, Magpantay also served as the primary caregiver in her family.
Filial customs pervade every culture, and research shows that nearly one in five Asian Americans self-identify as a family caregiver.
When her son, Isaac, 21, was born, it was with congenital heart disease. He’d endured four open heart surgeries in his adolescence and Magpantay fulfilled years of post-surgery care.
“I noticed that he was flaring up with all these skin allergies. His breathing was getting really, really bad. I knew that the fire was getting to him,” Magpantay said.
In her sparse time off, she’d take him to doctors’ appointments.
Magpantay admits it was stressful. But it was not the first time she had to maintain the extreme and dogged balance between her work and personal life.
During the pandemic, she was enlisted to start the 1Heart location in Pasadena. The task overlapped with her father’s last moments.
From the Philippines she ‘reached for the U.S.’
Magpantay grew up in Marikina City in the Philippines. In “the Shoe Capital of the Philippines,” three generations were born and raised into the family shoe manufacturing business.
But Magpantay harbored silent aspirations. She didn’t want to rely on the family business to make a living. She saw many of her friends vacationing in Hong Kong during the summer.
“Why will I reach for Hong Kong, if I can reach for the U.S.?” she asked herself.
She left for the U.S. in 2000, a 21-year old recent college graduate, and ended up in Echo Park with a friend, where she became a nanny and met her husband.
For 13 years, she worked as a caregiver for a Jamaican family-owned business and sent money to family in the Philippines. Her employers gave her the flexibility to pursue a green card and complete a Licensed Vocational Nurse program.
Joseph Bernardo, historian, DEI director at Loyola Marymount University and co-host of the podcast “This Filipino American Life,” says the origins of the Filipino nursing labor niche is not coincidental. It spans back to more than a century ago, during the U.S. occupation of the Philippines.
American nursing programs were implemented after the Philippines became a U.S. colony in 1989 — an effort to “civilize” the Philippines. Just two years after the Philippines gained independence in 1946, the U.S. created the Exchange Visitor Program to allow foreign professionals to come to the States. Many Filipino nurses, spurred by their country’s declarations of martial law and already trained in American-style nursing, came to the U.S.
After the Philippines became a U.S. colony in 1898, the U.S. implemented American nursing programs in the Philippines in an effort to “civilize” the Philippines. Then, in 1946, just two years after the Philippines gained independence from the U.S., the U.S. created the Exchange Visitor Program, which allowed foreign professionals to come to the U.S. to spread American democracy across the world and fight Soviet propaganda. Many Filipino nurses, already trained in American-style nursing, came to the U.S., concentrating on the West Coast, home to 41% of Filipino immigrants and the largest Filipino diaspora.
In 1965, the Immigration and Nationality Act allowed a larger number of immigrants from around the world to come to the States. There was a critical shortage of nurses following WWII and U.S. hospitals advertised to Filipino nurses who filled that gap.
The Philippines continues to be the leading exporter of professional nurses to the States. About one-third of all foreign-born nurses in the U.S. are Filipino. Since the 1960s, there have been more than 150,000 Filipino nurses who have migrated to the U.S. A 2019 study showed that one out of 20 nurses was trained in the Philippines.
And today, it’s not solely Filipino immigrants who are nurses, but also multiple generations of U.S.-born Filipino Americans who are also nurses. The labor niche also created a pipeline for Filipino entrepreneurs.
“Filipino entrepreneurs started opening up care homes and larger facilities and they would run those,” Bernardo said, whose own parents started nursing homes in the San Fernando Valley in the 1990s.
While Filipinos comprise only 1% of the U.S. population, they make up 4% of the nursing workforce, according to a study by the National Institute of Health. During the Covid Pandemic, the harsh reality of this disparity was brought to light. Tragically, 24% of the nurses who died from COVID-19 complications were Filipino.
And in California, Filipino nurses account for 11 of the 16 COVID-19 deaths — nearly 70% — in the nursing profession, according to the California Nurses Association.
Bernardo uses words like “unseen” and “invisible” to describe the unsung heroes of the pandemic, Los Angeles fires and countless other disasters.
There’s little academic research on Filipino health-care workers, he said. And by nature, the care work and nursing professions demand a sort of social invisibility.
“They’re taking care of a patient and then they sleep in their quarters. It’s kind of like 24/7 on call for a lot of them,” Bernardo said.
“On their days off, they’ll gather at a certain place, they’ll go to church and certain places and that’s where they’ll socialize with other people. But for the most part, they’re tied to where they work and where they live.”
Work isn’t slowing down
Magpantay and her family have since settled back into their Pasadena home, now repaired and cleared of the soot.
She works “countless hours” and frequent 12 hour shifts — more than she used to — to help patients with their own fire-recovery journeys.
Now, in light of the immigration raids in L.A., she says many care workers are working extra hours as well, some even clocking in seven days a week, to provide for loved ones who’ve been deported or are at threat of deportation.
As of mid-2023, about 294,000, or 2% of all 13.7 million unauthorized immigrants in the U.S. were from the Philippines, according to the Migration Policy Institute. Though there isn’t data on the exact number of undocumented Filipino health-care workers, Bernardo said it’s common for the labor niche.
“Many of those folks are undocumented because of the informality of a lot of those roles,” he said.
Magpantay and 1Heart’s registered nurses were not personally affected, though she says many of their loved ones are.
“The grieving of the family, family members of your own employees” — that’s a tangible shift in the work attitude, Magpantay said.
“My nurses keep telling me, ‘I need more work because my husband is not able to work because he cannot go out of the house,’” she said. “This types of conversation is more frequent than ever for me and my HR team.”
Magpantay doesn’t see herself stopping or slowing down anytime soon. She’s in the process of enlisting more clients.
In 2023, Magpantay’s friend Belina Calderon-Nernberg, CEO and founder of 1Heart, enlisted her to sign clients to get the then-new Pasadena location off its feet.
During the pandemic, however, her father’s colon cancer resurged. She split her time between him and 1Heart — all while working as a nurse. But by April 2023, it was clear that recovery was unlikely.
“That’s the hardest part. Being a daughter and a nurse at the same time,” she said. “I want to fight for him. But I can read the prognosis.”
The morning of Apr. 16, two days after Magpantay’s 44th birthday, she planned to visit her father at Huntington Health. But she overslept. She’d been working around the clock to secure clients for 1Heart Pasadena.
When she went to visit her father that afternoon, he asked about 1Heart.
“‘Oh, Dad, that’s why I was late because I signed up a lot of patients. Don’t worry about us. We’re gonna be okay.’ And then he started to be so happy. But I lied. I didn’t sign up any clients that time. I know he was at peace when I told him that.”
That same night, her father passed.
Less than three months later, in June, Magpantay signed her first clients. She told them they could trust 1Heart, that she knew how it felt to have a sick loved one and what it meant to provide care.
“There’s nothing more painful than losing my dad and going through all the surgeries for my son. So everything else, I’m able to do that,” she said. “Even the fire.”
Victoria Le is a reporter with the Southern California News Group. This project was completed during her summer internship with the Pasadena Star-News. The internship, in conjunction with the Asian American Journalists Association’s L.A. chapter, explores topics within the region’s Asian American and Pacific Islander communities.